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Learning to Walk Again
As a teeanger, I, like many others, thought myself to be invincible. No one expects to get surgery at 16 years old. Especially a surgery that takes months, even years of recovery.
In September 2016, I was playing soccer and another player ran into me. I took a step forward and immediately my leg gave out from underneath me. While I was in a pain at the time, it soon went away and I carried on normally. A month after the initial injury, my leg collapsed again, during gym class. One of my friends laughed, thinking I had fallen over. Another one saw the panic written across my face and picked me up and sat me down somewhere so I could get ice. That night, my mom convinced me to finally get my knee professionally checked out. A doctor's appointment and a reluctant MRI scan later, I had the results. I had completely torn my ACL.
It’s understandable that I was pretty upset. It’s also understandable that I was hesitant to believe the results. Afterall, I had been running on my leg for a month after my initial injury with no problems. What was hard for people to truly understand was the complete and utter devastation I felt in that moment.
Initially, doctors tried to reassure me by claiming that I was relatively lucky to have not torn my meniscus or any other part of my knee. It was a miracle I had been even walking on it for this long! However, to me, the news that I would be out for the rest of my cross country season, and would be in recovery well into the summer, was the worst news ever.
Running cross country meant, and still means, the world to me. It was a passion I discovered in freshman year of high school, and it was something I never wanted to give up. In the fall months, my life would revolve around this sport. In the off-season months, staying in shape was always on my mind. Being able to hop on a treadmill or go for a jog whenever I wanted to was a hobby I took for granted, and didn’t realize how big of an impact it had on my life until that ability was taken away from me.
On November 8, 2016, I underwent a hamstring graft ACL reconstructive surgery. Thankfully, the surgery went smoothly. I can remember most of the events leading up to the surgery, despite being given a small dose of anesthesia. I remember being moved from the bed to the actual surgery table. I remember being strangely calm while counting down from 10, and waking up to the nurses still checking my vitals. The surgery was a success.
Nothing prepared me for the sensation of waking up and not being able to feel my leg. Obviously I knew that my leg would be numb, and I knew that I wasn’t going to be able to use or move my leg for a while. But the feeling that I was missing a part of my body, despite knowing it was there, really freaked me out. Finally it hit me, my leg would never be the same.
The first real challenge came a week after. Of course there were the expected struggles of the constant dull ache, the having to use crutches everywhere, the inability to sit or lie down comfortably, the first small steps of physically therapy, etc. all of which I was prepared to handle. What I wasn’t prepared for was ending up in a wheelchair the following Wednesday. A couple days after my surgery I was able to bend my knee a small fraction. Over the weekend, I was able to stand on both legs without the use of crutches. On Monday morning I returned to school, in reasonably high spirits. The first school day back was exhausting both physically and mentally. But that night, I started experiencing pain when I would stand up.
Since I had never had surgery before, I thought the pain was normal. Afterall, I had been told about the surgery and what to expect from a friends that had undergone the same experience. What was happening was that when I would stand up, my leg would immediately start feeling immense amounts of sharp pain, as opposed to the dull ache I had grown accustomed to. The only relief from this pain was if I grabbed the full leg brace I was in and held the weight of my leg instead of letting it hang. The problem with this was I could stand, but I couldn’t use crutches while only using one arm. The pain gradually got worse throughout the week, until Wednesday my walk from my first class to my second ended in tears and I was given a school wheelchair to use the rest of the day.
I felt awful. Not only was I in massive amounts of pain, but I felt like i was going backwards. A couple days prior, I was able to stand without crutches and without pain. Now I was confined to a wheelchair and the slightest bit of a bump had me wincing. What had I done wrong that had me going from improving to being confined to a wheelchair?
My parents scheduled me an emergency visit at the hospital where I had gotten my surgery. There I met with a lovely nurse practitioner who, while very considerate and kind, could not figure out what had gone wrong. The two ideas she narrowed it down to were that I had had Complex Regional Pain Syndrome (CRPS) or I had become non-responsive to the pain medication I was using. CPRS is where the nerves in your body, particularly a specific limb, start experiencing every slight touch or movement, no matter how light, as pain. The problem with this theory was that CPRS is typically a broad syndrome, meaning it should have impacted my entire knee. The nurse practitioner was able to pinpoint the pain to two specific points, about the size of a quarter, on my knee that when pressed was giving me the most pain. The second theory was that I was non-responsive to the pain medication that I had been prescribed. While it was the more common, and more likely theory, there were some problems. The pain medication had seemed to be working for me over the weekend, and building a tolerance to the medicine does not occur that quickly.
Despite being in massive amounts of pain, the doctors were hesitant to give me new drugs. Being a teenager, stronger pain medication led to a higher potential for addiction, and the doctors didn’t even know if a lack of response to the medicine was what was causing my pain. Eventually, I was prescribed a different pain medication. I was prescribed the minimum amount, and was told that even if the new medicine did work I wouldn’t be able to obtain any more than the weeks worth they were giving me. Thankfully, it worked. The next day, I was able to poke at the pressure points on my knee and I experienced no pain. Now, a week and a half later, I could officially start the recovery process. That day, I felt on top of the world again. However, the struggle was far from over.
The beginning of physical therapy was some of the toughest, yet most rewarding weeks of my life. Once I wasn’t in a lot of pain, I started the exercises I had been given. Within a couple weeks, I was able to bend my leg 60°. After 2 weeks, I was allowed to forgo the crutches and walk with my leg straight, still in the brace. After a month I was allowed to open the brace to allow my leg to bend 30° during the day. I went back to work before my brace was off. By Christmas, I was allowed to take the brace off whenever I wanted.
Some of the toughest mental challenges came when I was finally allowed to bend the brace. I had been off my leg for 2 weeks, and I had finally adapted to walking with a stiff leg. I had lost 30% of my quad muscle strength. I spent weeks in physical therapy trying to learn how to walk again. I had to be taught, like a baby, the proper way to walk, regain the muscle to be able to lift my leg over a plastic cone, bend my leg enough so that my foot doesn’t brush the ground, and land on the proper part of my feet. Not only that, but I had to regain the strength and stability to balance just on my left leg as I lifted the other easily over the cone. During the day, I would catch myself walking incorrectly, and would mentally walk myself through the steps of taking proper steps. Having to be constantly aware of how my body was acting every second of every day was exhausting. Never before did I think that something as simple as lifting my leg a couple inches would cause such a struggle.
Along with the mental tests came the physical challenges as well. Squats, lunges, jumping, balancing, everything that used to be easy was now posing a challenge. About 10 weeks in I hit a block. I was rapidly improving and one day it seemed I just took all the steps backwards. I wasn't able to bend my leg farther than the week before, I was in pain doing simple tasks, and everything seemed to get more difficult. I mentally started giving up. Why do the exercises at home if nothing was improving? I had no confidence, and no motivation.
My mood throughout the recovery process started rapidly shifted in a negative way. I tried to put on a happy and friendly face at school, but at home I was miserable. My grades slipped because I didn't have enough energy or motivation to study. I snapped at my family on multiple occasions. Normally when I would have a stressful week, I would go for a run. I never realized how dependent my mental health was on my running until it was taken away from me.
The months after surgery I had what I have named “post-surgery depression”. After major surgeries, particularly if it is someone's first surgery, many patients suffer from depression-like symptoms and mood swings. There were moments when I seriously questioned getting out of bed in the morning knowing that my entire day would be a disappointing struggle until I went to bed again that night.
It is important to note than when making the decision of where I should get my surgery, I chose the surgeon because he was more experienced in the hamstring graft process, and he promised me that I would be running again at 12 weeks. So at the 12 week mark, my physical therapist had told me about a machine that measured the difference in muscle strength between my right and left leg. To be able to starting running again, they wanted a smaller than 25% difference in strength between my legs. I think some part of me knew going in that day that my legs weren't even in strength. My quad muscle had a visible difference in size, and my left hamstring would get sore far before my right would. But I kept telling myself that if I pushed myself really hard, I would be allowed to run again. Afterall, hard work and perseverance was what kept me going and improving through the cross country season, of course it wouldn’t fail me! But when I took the test and was told that there was too much of a difference between my right and left leg and wouldn’t be allowed to start running for another 4 weeks, I was devastated.
I was hurt. Devastated. Angry. And rightfully so! I had been promised-PROMISED-that I would be running by 12 weeks. Well that day came and I was told that maybe in the next 4 weeks I would be able to. I felt betrayed.
That night, I went to a path that I always used to run at. I was going to run again, and I was going to run a mile no matter what the physical therapist said. Admittedly, this was not one of the best decisions I made during my surgery. My brother, who was supposed to be attending soccer practice, decided he would follow me so I wouldn’t hurt myself. I got to the field, starting jogging, and immediately started having sharp pain every time my foot touched the ground. I could tell immediately, this was not muscle loss. This was just pain from the new ligament and the holes in my bone. I tried to push through the pain, because that was what I used to during the cross country season. If I was in pain, it meant I was working hard, it meant I was improving, it meant I could push through it. But this was a different injury, and a different time. I stopped, sobbing. My brother tried to get me to go back to our car and go home, but I refused. I was going to finish that mile, even if I had to crawl the entire lap. So me and my brother walked, with the occasional pain-filled attempt at jogging only to stop a couple of strides in, and we finished a mile lap. I went home and, in what was becoming a common occurrence during my recovery, cried. A lot.
That night was one of the times I felt the worst. As much as I kept telling myself that I would improve, that I couldn’t let a little setback upset me, I felt like I was lying to myself. I was never going to be able to run again, I would for the rest of my life be in pain, my cross country career, and thus the thing that was most important to me, was ruined. Looking back, I had let fear and disappointment dictate my thoughts. With something as major as surgery, there will always be hindrances, there will always be mountains to climb. It wasn’t until I had overcome the hardship that I was able to look back at how far I’ve come since that night.
After I left physical therapy that day, I never went back. Where I had been going was far away, and I had been planning on going to one closer to my house for a while. I felt that they had betrayed my trust by allowing me to believe that their program was the one that was going to allow me to get back to running the fastest. So I left and went to a different place.
After that infamous 12 week fiasco there were many small victories and pitfalls, but nothing as drastic as that night. At the new physical therapy center, I was immediately allowed to start running on an anti gravity treadmill. This allowed me to run and try to regain my stamina, but took some of the weight off my knee so that I wasn’t in pain. I was given a new exercise regimen, but with some very similar elements. Physical therapy became part of my normal, and while it remained an important part of my day, I didn’t let my life revolve around it.
Slowly but surely I made progress, but I still felt held back. While I was still in small amounts of pain, I felt that I should be allowed to run for longer periods of time, or faster, or taking less weight off. The limitations that were placed on me week after week were just short of how far I wanted to push myself. At first, I followed the rules. I understood that these were the professionals, that they had my best interest in mind, and that they were restricting me so that I didn’t reinjure myself or do anything harmful. However, as the weeks dragged on, I couldn’t get the doubts out of my head that they were holding me back purely for the sake of keeping me in therapy longer.
Through the course of physical therapy I had to become very well in-tune with my own body, because I payed it so much attention on a daily basis. I had learned to specifically target certain muscles, and when I was sore I knew exactly what my body was going to do to try to counteract it. I could start to sense myself running unevenly before the machine would, and I learned how to stop my body from “cheating” to accomplish certain tasks that I should be using my weaker muscles for. So after awhile, I started doing exercises that I felt would push me and get me back to the strength and stamina I wanted to be at, without causing myself serious injury.
One day, I decided enough was enough and I wanted to make a decision that I felt was best for my sanity without compromising my health. When I felt that I wasn’t going to be in pain when I ran, I went against my physical therapist’s wishes, and went for a run. It was a warm week in April, and I had been particularly depressed that week for one reason or another. I went to track practice to help out, as I had been doing for most of the season, and decided right there that I was going to run with the team on their warm up whether I was supposed to or not. About 10 minutes into the warm up, I started crying. Immediately my teammates urged me to stop, thinking I was in pain. But what they didn’t realize was that for the first time since my surgery, I was crying tears of happiness. I don’t know if it was the adrenaline or if I was just having a good day, but I was in no pain. That initial 10 minutes I was planning turned into 50 minutes, and I couldn’t be happier. From then on, I would run with my teammates whenever they had a long run as part of the their workout. My coach tried to limit what I was running to at least attempt the schedule I was supposed to be following, but my enthusiasm at being able to run finally I think made him reluctant to stop me. Being around my friends again was some of the best motivation I could have ever used, because no matter how bad of a day I was having, they always pushed me to keep going.
I would love to say that everything went smoothly from that day forward. Of course it didn’t. I was eventually given the official clearance to be allowed to start running off of a treadmill, but was still restricted in how much I was supposed to be running. Jumping and squatting exercises were still creating issues, and there were weeks where it was hard to have the motivation to run because every time I would try I would end up in pain. Pain that I knew I shouldn’t still be in. Motivation reached an all time low around 6 months. I felt that I had come so far from my surgery and accomplished nothing toward the goal I wanted to get back to. How was I ever going to get back to the strength I was at before if I couldn’t run more than 20 minutes without ending up in a limp? One particularly bad day my brother came into the basement where I was running on our treadmill and found me crying. Not because I was in massive amounts of pain (granted, I was in some slight pain), but because I had lost all motivation for running. The lack of progress I was experiencing was turning me away from the sport I loved.
Looking back and realizing I was in less pain running in the months between my injury and my surgery, when I was running on a torn ACL, than some days when I am running now is one of the hardest hurdles to overcome. Still today, many months later, I am still experiencing pain when I run. It’s frustrating at times, it’s extremely demoralizing, but whenever I think about returning to my senior year cross country season I am encouraged all over again. Next fall I will be joining the team again with no idea how my racing is going to be. Going into it I know that the chances of me tearing my other ACL are now higher than before. But I know if I work really hard over the summer, there’s a chance I will come back even better than before.
Every day poses new challenges, new hurdles, but surrounding myself with family and friends that encourage and inspire me every day is one of the best methods of recovery. I try not to measure progress on how much I’ve lost from a year ago, but on how far I’ve come from my surgery, and how much I’ve accomplished since I’ve had to start over.